Cleveland
Clinic Innovations hosts the Medical Innovation Summit every Fall to bring
together all stakeholders in healthcare industry to advance the conversation of
medical innovation. They not only discuss the medical breakthroughs in the
current year and but also sketch the blueprint for forthcoming innovations in
the coming year.
The
stakeholders in the summit includes investors, entrepreneurs, researchers,
scientists and government personnel and policy makers that will influence the
development and marketing of the new discoveries.
This
year the summit was held from October 24-26,2016 at Cleveland, Ohio.
The top
ten medical innovations for the year 2016 are:
1) Vaccines to
Prevent Public Health Epidemics.
The top
spot in the top ten medical innovation list goes to researchers, scientists and
public health personnel who are working tirelessly to develop safe, efficient
and effective vaccines to prevent disease epidemics. These efforts were geared
up by the 2014 Ebola epidemic in Africa and of bacterial meningococcal
(Meningococcal B) outbreaks in the United States. The most promising Ebola
vaccines was fast-tracked in less just a year. The researchers incorporated a
small fragment of surface protein into a harmless cattle vaccine, which retains
its capacity to generate a full blown immune response, but loses its ability to
cause disease. Phase-3 clinical trials
in population with full exposure to Ebola virus has shown 100% efficacy in just
10 days.
Similarly,
the Meningococcal B vaccine is freely available to all in the year 2016.[1]
2) Genomic
Directed Clinical Trials
Identification
of essential tumor growth drivers has initiated a new era of targeted genomic cancer
therapy. It gives cancer patients a higher chance of survival, longevity and
best chance of cure when they need it most. Patients are waiting too long to
enter clinical trials which may decrease their chances of cure or survival. RCT
which has long been the gold standard of clinical trials are not keeping in
pace with rapid expanding world of gene based and genomic therapy. Genomic
based clinical trials can help identify the molecular profile of patient cancer
cells and help getting them faster into clinical trials. Those patients with
rare type of cancers can also hope for a cure due to genomic trials.
3) Gene Editing Using CRISPR
CRISPR
or clustered, regularly interspaced, short palindromic repeat (CRISPR) is a
versatile tool for genome engineering used to generating RNA-guided nucleases,
such as Cas9, with customizable specificities. It has many innovative
application from treating diseases to editing the genes of human embryos to
eliminate many genetic diseases. [2]
4) Water
Purification Systems for Prevention of Infectious Diseases.
Developing
countries all over the world are struggling to provide clean drinking water to
its majority of population. Sewage often pile up and eventually end up
contaminating the drinking water. This contributes to more than 10% of disease
in the world
An estimated 700million people in the world are drinking contaminated water
According to the world health organization - more than a million children under
the age of five (in developing countries) die each year as a result to
contaminated water and poor sanitation [3]
LifeStraw has developed a system which transforms sewage into safe drinking
water, not for a small group of people but larger communities for extended period
of time. The machine collects the waste from the sewage then boils it and collects
the condensed water vapor and process it into clean and safe drinking water. One
processor is said to generate enough water for 100,000 people.[4]
5) Cell-Free Fetal
DNA Testing
In USA, cell-free DNA analysis became clinically available in 2011
and the American College of Obstetricians and Gynecologists and the Society for
Maternal–Fetal Medicine recommended it as a screening option for women at
increased risk of fetal aneuploidy. Its use has since been expanded as a
screening tool in general obstetric population.Fetal circulating cell free DNA
is derived mostly from placenta and is present in maternal blood for testing as
early as 10 weeks of gestation. Different laboratories have validated different
techniques and mainly rely on next-generation sequencing technologies and
advanced bioinformatic analyses.Cell free DNA is commonly used to screen for
only the common trisomies and, if requested, sex chromosome composition. The
sensitivity and specificity as well as the negative predictive value of the
method is >99% for trisomy 21 (Down syndrome), with slightly lower
performance for trisomy 13 and 18.
6) Cancer
Screening via Protein Biomarker Analysis
Scientist and researchers
have long focused on detection of change in concentration of single protein in
biological fluids such as blood or urine to screen for cancer. But, the tests have
been of limited use due to low sensitivity and specificity. Currently Studying
cancer proteomics holds promise in near future to detect tell-tale proteins that
provides insight into biological process of alteration in protein due to
cancer. This is very true for detection of prostate cancer and colorectal
cancers.
The Lerner Research Institute (LRI) of the
Cleveland Clinic maintains the Proteomics Core, a protein-sequencing facility
that uses tandem mass spectrometry methods to sequence and identify proteins. [5]
In an Australian study published in PLOS one
Fung KYC et al identified three biomarkers that discriminated between the
controls and the colorectal cancer patients with 73 percent sensitivity at 95
percent specificity.[6]
Similarly tests for prostate cancer showed 100 percent sensitivity with no
false negatives and approximately 80 percent specificity.
7) Naturally Controlled Artificial Limbs
Numerous
innovations in prosthetics over the last decade have improved quality of life
for numerous amputees and paraplegics in United States. Researchers have discovered
that neural signals for limb movements can be de-coded by computers. This
advance was made possible by technologies developed under Defense Advanced Research Projects Agency. Now
people living with missing or paralyzed limbs will be able to get a feel of the
objects they are touching via prosthesis but also will be able to send signals
to the robotic prosthesis device form brain.
“We’ve
completed the circuit,” said DARPA program manager Justin Sanchez.
“Prosthetic limbs that can be controlled by thoughts are showing great promise,
but without feedback from signals traveling back to the brain it can be
difficult to achieve the level of control needed to perform precise movements.
By wiring a sense of touch from a mechanical hand directly into the brain, this
work shows the potential for seamless bio-technological restoration of
near-natural function.”[7]
8) First-ever
Treatment For HSDD
The little
pink pill or Flibanserin (Addyi, Sprout Pharmaceuticals) also
dubbed as the "Female Viagra" was approved by the US
Food and Drug Administration (FDA) for the treatment of hypoactive
sexual desire disorder (HSDD) in premenopausal women, in August
2015, despite being unsure about suboptimal risk-benefit
trade-offs.
Flibanserin,
a 5-HT1A agonist, a 5-HT2A antagonist, and a very weak partial agonist on
dopamine D4 receptors, increases levels of dopamine and norepinephrine and
decreases serotonin in animal brain areas. Therefore, since dopamine and
norepinephrine are thought to promote and serotonin is thought to inhibit
sexual desire and arousal, it was suggested that flibanserin enhances sexual
desire in HSDD.
9) Frictionless
Remote Monitoring
Monitoring the
blood glucose by pricking the finger will soon be a thing of past.
Wearable biosensors now measure glucose levels using tissue fluids like tears and sweat
and not blood. The WBS transmits data over WiFi to
the mobile receiver. The patient hence will be able to continuously monitor his
or her glucose level and share the results with healthcare providers. Other
frictionless remote monitoring devices in development include a bandage that
reads sweat molecules to diagnose pregnancy, hypertension or hydration.[8]
10) Neurovascular
Stent Retriever
Neurovascular
stent retrievers are a crucial type of medical equipment used in the treatment
of strokes. They are used to clear up intracranial arteries and restore normal
blood flow following a stroke. Their rapid action in clearing arteries and
retrieving clots in large arteries has been noted by health-care authorities
after preliminary trials showed promising results. In June, the American Heart
Association and American Stroke Association updated its guidelines
and added the use of stent retrievers in conjunction with tPA for
first-line treatment in some patients with acute ischemic stroke. The stent
retrievers are the Solitaire (Medtronic) or Trevo ProVue (Stryker).
[1] http://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations/Top-10-for-2016/1-Vaccines-to-Prevent-Public-Health-Epidemics.aspx
[2] http://www.nature.com/news/crispr-gene-editing-is-just-the-beginning-1.19510
[3] https://prezi.com/crxawgoncdfn/water-purification-systems-for-prevention-of-infectious-dise/
[4] http://www.ippinka.com/blog/lifestraw-water-purification-project-for-millions/
[5] http://journals.lww.com/oncology-times/blog/onlinefirst/Pages/post.aspx?PostID=1352
[6] Fung
KYC, Tabor B, Buckley MJ, Priebe IK, Purins L, Pompeia C, et al. (2015)
Blood-Based Protein Biomarker Panel for the Detection of Colorectal Cancer.
PLoS ONE 10(3): e0120425. doi:10.1371/journal.pone.0120425
[7] http://www.darpa.mil/news-events/2015-09-11
[8] https://www.mepits.com/tutorial/180/Biomedical/Wearable-Biosensors
